Using Motivational Interviewing with Serious Mental illness to Address Medication Non-Adherence, Create Change and Enhance Stability-View Presentation Slides

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The document from the American Psychiatric Association outlines the use of Motivational Interviewing (MI) to address medication non-adherence among individuals with serious mental illness (SMI). Led by Christopher W. Link, the session aims to provide insights into MI's efficacy and application in enhancing medication adherence.<br /><br />The document highlights several key learning objectives for participants: understanding medication non-adherence through the lens of ambivalence specific to MI, adapting MI to work with both positive and negative symptoms commonly associated with SMI, and utilizing value-card sorting within MI sessions to evoke change talk and enhance patient stability.<br /><br />Medication non-adherence is discussed in terms of compliance (negative connotation of patients being subservient to prescribers) and adherence (correspondence between medication intake and healthcare provider recommendations). Non-adherence can be intentional, due to an active decision-making process, or unintentional, stemming from forgetfulness or improper medication usage. <br /><br />Culture plays a significant role in medication adherence and MI adaptation, emphasizing the need for culturally competent care. Different methodologies within MI, like language-concordant services and implicit bias training, are suggested to improve patient engagement and outcomes.<br /><br />The document details evidence of MI's effectiveness. Although limited, studies show MI can potentially increase medication adherence, with variables such as the length and structure of sessions influencing outcomes. Clinical challenges with MI involve handling cognitive impairments and both positive and negative symptoms of SMI, suggesting modifications like use of concrete materials and visual aids can enhance engagement.<br /><br />The document expresses caution in using MI, recommending alternative approaches if patients become too disorganized during sessions. Ultimately, persistent MI training and culturally adapted interventions are emphasized as critical to improving its effectiveness in patient care.

Keywords

Motivational Interviewing

medication non-adherence

serious mental illness

culturally competent care

value-card sorting

cognitive impairments

patient engagement

implicit bias training

positive and negative symptoms

Christopher W. Link